Generic Name: multivitamin with iron (MUL tee VYE ta mins with i ron)



Generic Name: hypromellose (Ophthalmic route)

hye-PROE-me-lose

Commonly used brand name(s)

In the U.S.

Genteal Genteal Mild Gonak Goniosoft Goniovisc Isopto Tears Nature's Tears Tearisol Tears Again Mc

Available Dosage Forms:

Solution Gel/Jelly

Therapeutic Class: Surgical Aid, Ocular

Uses For Genteal Mild

Hydroxypropyl methylcellulose belongs to the group of medicines known as artificial tears. It is used to relieve dryness and irritation caused by reduced tear flow. It helps prevent damage to the eye in certain eye diseases. Hydroxypropyl methylcellulose may also be used to moisten hard contact lenses and artificial eyes. In addition, it may be used in certain eye examinations.

Some of these preparations are available only with your doctor's prescription.

Before Using Genteal Mild

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Although there is no specific information comparing use of hydroxypropyl methylcellulose in children with use in other age groups, this medicine is not expected to cause different side effects or problems in children than it does in adults.

Geriatric

Many medicine have not been studied specifically in older people. Therefore, it may not be known whether they work exactly the same way they do in younger adults. Although there is no specific information comparing use of hydroxypropyl methylcellulose in the elderly with use in other age groups, this medicine is not expected to cause different side effects or problems in older people than it does in younger adults.

Pregnancy Pregnancy Category Explanation All Trimesters C Animal studies have shown an adverse effect and there are no adequate studies in pregnant women OR no animal studies have been conducted and there are no adequate studies in pregnant women. Breast Feeding

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Interactions with Medicines

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. Tell your healthcare professional if you are taking any other prescription or nonprescription (over-the-counter [OTC]) medicine.

Interactions with Food/Tobacco/Alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Proper Use of hypromellose

This section provides information on the proper use of a number of products that contain hypromellose. It may not be specific to Genteal Mild. Please read with care.

To use:

First, wash your hands. Then tilt the head back and pull the lower eyelid away from the eye to form a pouch. Drop the medicine into the pouch and gently close the eyes. Do not blink. Keep the eyes closed for 1 or 2 minutes to allow the medicine to be absorbed. To keep the medicine as germ-free as possible, do not touch the applicator tip to any surface (including the eye). Also, keep the container tightly closed.

For patients wearing hard contact lenses:

Take care not to float the lens from your eye when applying this medicine. If you have any questions about this, check with your health care professional. Dosing

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

For dry eyes: For ophthalmic solution (eye drops) dosage form: Adults and children—Use 1 drop three or four times a day. Storage

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Precautions While Using Genteal Mild

If you experience eye pain, changes in vision, continued redness or irritation of the eye, or if your symptoms continue for more than 3 days or become worse, check with your doctor.

Genteal Mild Side Effects

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

Eye irritation not present before use of this medicine

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

Less common - more common with 1% solution Blurred vision matting or stickiness of eyelashes

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

The information contained in the Thomson Reuters Micromedex products as delivered by Drugs.com is intended as an educational aid only. It is not intended as medical advice for individual conditions or treatment. It is not a substitute for a medical exam, nor does it replace the need for services provided by medical professionals. Talk to your doctor, nurse or pharmacist before taking any prescription or over the counter drugs (including any herbal medicines or supplements) or following any treatment or regimen. Only your doctor, nurse, or pharmacist can provide you with advice on what is safe and effective for you.

The use of the Thomson Reuters Healthcare products is at your sole risk. These products are provided "AS IS" and "as available" for use, without warranties of any kind, either express or implied. Thomson Reuters Healthcare and Drugs.com make no representation or warranty as to the accuracy, reliability, timeliness, usefulness or completeness of any of the information contained in the products. Additionally, THOMSON REUTERS HEALTHCARE MAKES NO REPRESENTATION OR WARRANTIES AS TO THE OPINIONS OR OTHER SERVICE OR DATA YOU MAY ACCESS, DOWNLOAD OR USE AS A RESULT OF USE OF THE THOMSON REUTERS HEALTHCARE PRODUCTS. ALL IMPLIED WARRANTIES OF MERCHANTABILITY AND FITNESS FOR A PARTICULAR PURPOSE OR USE ARE HEREBY EXCLUDED. Thomson Reuters Healthcare does not assume any responsibility or risk for your use of the Thomson Reuters Healthcare products.



Generic Name: metformin (Oral route)

met-FOR-min hye-droe-KLOR-ide

Oral route(Tablet;Tablet, Extended Release;Solution)

Fortamet(R), Glucophage(R), Glucophage XR(R), Riomet(R): Lactic acidosis is a rare, but serious, metabolic complication that can occur due to metformin accumulation during treatment with metformin hydrochloride; when it occurs, it is fatal in approximately 50% of cases. Lactic acidosis may also occur in association with pathophysiologic conditions, including diabetes mellitus, characterized by significant tissue hypoperfusion and hypoxemia. The risk of lactic acidosis increases with renal impairment, increased age, congestive heart failure, and hepatic insufficiency. Treatment with metformin should not be initiated in patients 80 years old or older, unless measurement of creatinine clearance demonstrates that renal function is normal. Therapy should temporarily be discontinued prior to any intravascular radiocontrast study or surgical procedure. Excessive alcohol use should be avoided, because alcohol potentiates the effects of metformin on lactate metabolism. Discontinue therapy immediately and institute supportive measures promptly for suspected lactic acidosis .

Oral route(Tablet, Extended Release)

Glumetza(R): Lactic acidosis is a rare, but serious, complication that can occur due to metformin accumulation. The risk of lactic acidosis increases with renal or hepatic impairment, acute congestive heart failure, sepsis, dehydration, and excess alcohol intake. Onset may be subtle and include nonspecific symptoms such as malaise, myalgia, respiratory distress, somnolence, and abdominal distress; laboratory abnormalities include low pH, increased anion gap and elevated blood lactate. If lactic acidosis is suspected, Glumetza(R) should be discontinued and the patient immediately hospitalized .

Commonly used brand name(s)

In the U.S.

Fortamet Glucophage Glucophage XR Glumetza Riomet

Available Dosage Forms:

Tablet Tablet, Extended Release Solution

Therapeutic Class: Hypoglycemic

Chemical Class: Metformin

Uses For Glucophage

Metformin is used to treat high blood sugar levels that are caused by a type of diabetes mellitus or sugar diabetes called type 2 diabetes. With this type of diabetes, insulin produced by the pancreas is not able to get sugar into the cells of the body where it can work properly. Using metformin alone, with a type of oral antidiabetic medicine called a sulfonylurea, or with insulin, will help to lower blood sugar when it is too high and help restore the way you use food to make energy.

Many people can control type 2 diabetes with diet and exercise. Following a specially planned diet and exercise will always be important when you have diabetes, even when you are taking medicines. To work properly, the amount of metformin you take must be balanced against the amount and type of food you eat and the amount of exercise you do. If you change your diet or exercise, you will want to test your blood sugar to find out if it is too low. Your doctor will teach you what to do if this happens.

Metformin does not help patients does not help patients who have insulin-dependent or type 1 diabetes because they cannot produce insulin from their pancreas gland. Their blood glucose is best controlled by insulin injections.

This medicine is available only with your doctor's prescription.

Once a medicine has been approved for marketing for a certain use, experience may show that it is also useful for other medical problems. Although this use is not included in product labeling, metformin is used in certain patients with the following medical conditions:

Polycystic ovary syndrome. Before Using Glucophage

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Appropriate studies performed to date have not demonstrated pediatric-specific problems that would limit the usefulness of metformin oral solution and tablets in children 10 to 16 years of age. However, safety and efficacy of metformin extended-release tablets in the pediatric population have not been established.

Geriatric

Although appropriate studies on the relationship of age to the effects of metformin have not been performed in the geriatric population, geriatric-specific problems are not expected to limit the usefulness of metformin in the elderly. However, elderly patients are more likely to have age-related kidney problems, which may require caution in patients receiving metformin. This medicine is not recommended in patients 80 years of age and older who have kidney problems.

Pregnancy Pregnancy Category Explanation All Trimesters B Animal studies have revealed no evidence of harm to the fetus, however, there are no adequate studies in pregnant women OR animal studies have shown an adverse effect, but adequate studies in pregnant women have failed to demonstrate a risk to the fetus. Breast Feeding

Studies in women suggest that this medication poses minimal risk to the infant when used during breastfeeding.

Interactions with Medicines

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

Acetrizoic Acid Diatrizoate Ethiodized Oil Iobenzamic Acid Iobitridol Iocarmic Acid Iocetamic Acid Iodamide Iodipamide Iodixanol Iodohippuric Acid Iodopyracet Iodoxamic Acid Ioglicic Acid Ioglycamic Acid Iohexol Iomeprol Iopamidol Iopanoic Acid Iopentol Iophendylate Iopromide Iopronic Acid Ioseric Acid Iosimide Iotasul Iothalamate Iotrolan Iotroxic Acid Ioversol Ioxaglate Ioxitalamic Acid Ipodate Metrizamide Metrizoic Acid Tyropanoate Sodium

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

Acetazolamide Alatrofloxacin Balofloxacin Cimetidine Ciprofloxacin Clinafloxacin Dichlorphenamide Dofetilide Enoxacin Fleroxacin Flumequine Gatifloxacin Gemifloxacin Grepafloxacin Levofloxacin Lomefloxacin Moxifloxacin Norfloxacin Ofloxacin Pefloxacin Prulifloxacin Rufloxacin Sparfloxacin Temafloxacin Topiramate Tosufloxacin Trovafloxacin Mesylate Zonisamide

Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

Acebutolol Alprenolol Atenolol Betaxolol Bevantolol Bisoprolol Bitter Melon Bucindolol Carteolol Carvedilol Celiprolol Cephalexin Clorgyline Dilevalol Enalaprilat Enalapril Maleate Esmolol Fenugreek Glucomannan Guar Gum Iproniazid Isocarboxazid Labetalol Levobunolol Mepindolol Metipranolol Metoprolol Moclobemide Nadolol Nebivolol Nialamide Oxprenolol Pargyline Penbutolol Phenelzine Pindolol Procarbazine Propranolol Psyllium Rifampin Selegiline Sotalol Talinolol Tertatolol Timolol Toloxatone Tranylcypromine Trospium Interactions with Food/Tobacco/Alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Other Medical Problems

The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

Alcohol, excessive use or Underactive adrenal glands or Underactive pituitary gland or Undernourished condition or Weakened physical condition or Any other condition that causes low blood sugar—Patients with these conditions may be more likely to develop low blood sugar while taking metformin. Anemia (low levels of red blood cells) or Vitamin B12 deficiency—Use with caution. May make these conditions worse. Congestive heart failure, acute or unstable or Dehydration or Heart attack, acute or Hypoxemia (decreased oxygen in the blood) or Kidney disease or Liver disease or Sepsis (blood poisoning) or Shock (low blood pressure, blood circulation is poor)—A rare condition called lactic acidosis can occur. Talk with your doctor if you have concerns about this. Diabetic ketoacidosis (ketones in the blood) or Kidney disease, severe or Metabolic acidosis (extra acids in the blood) or Type 1 diabetes—Should not be used in patients with these conditions. Fever or Infection or Surgery or Trauma—These conditions may cause temporary problems with blood sugar control and your doctor may want to treat you with insulin. Proper Use of metformin

This section provides information on the proper use of a number of products that contain metformin. It may not be specific to Glucophage. Please read with care.

This medicine usually comes with a patient information insert. Read the information carefully and make sure you understand it before taking this medicine. If you have any questions, ask your doctor.

Carefully follow the special meal plan your doctor gave you. This is a very important part of controlling your condition, and is necessary if the medicine is to work properly. Also, exercise regularly and test for sugar in your blood or urine as directed.

Metformin should be taken with meals to help reduce stomach or bowel side effects that may occur during the first few weeks of treatment.

Swallow the extended-release tablet whole with a full glass of water. Do not crush, break, or chew it.

While taking the extended-release tablet, part of the tablet may pass into your stool after your body has absorbed the medicine. This is normal and nothing to worry about.

Measure the oral liquid with a marked measuring spoon, oral syringe, or medicine cup. The average household teaspoon may not hold the right amount of liquid.

Use only the brand of this medicine that your doctor prescribed. Different brands may not work the same way.

You may notice improvement in your blood glucose control in 1 to 2 weeks, but the full effect of blood glucose control may take up to 2 to 3 months. Ask your doctor if you have any questions about this.

Dosing

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

For type 2 diabetes: For oral dosage form (extended-release tablets): Adults— Metformin alone (Fortamet®): At first, 1000 milligrams (mg) once a day taken with the evening meal. Your doctor may increase your dose if needed until your blood sugar is controlled. However, the dose is usually not more than 2500 mg per day. Metformin alone (Glucophage® XR): At first, 500 mg once daily with the evening meal. Your doctor may increase your dose if needed until your blood sugar is controlled. However, the dose is usually not more than 2000 mg per day. Metformin alone (Glumetza®): At first, 500 mg once a day taken with the evening meal. Then, your doctor may increase your dose if needed until your blood sugar is controlled. However, the dose is usually not more than 2000 mg per day. Metformin with a sulfonylurea: Your doctor will determine the dose of each medicine. Metformin with insulin: At first, 500 mg once a day. Then, your doctor may increase your dose by 500 mg every week if needed until your blood sugar is controlled. However, the dose is usually not more than 2500 mg per day. Children—Use and dose must be determined by your doctor. For oral dosage form (solution): Adults— Metformin alone: At first, 5 milliliters (mL) two times a day, or 8.5 mL once a day with meals. Your doctor may increase your dose if needed until your blood sugar is controlled. However, the dose is usually not more than 25.5 mL per day. Metformin with a sulfonylurea: Your doctor will determine the dose of each medicine. Metformin with insulin: At first, 5 mL once a day. Your doctor may increase your dose if needed until your blood sugar is controlled. However, the dose is usually not more than 25 mL per day. Children 10 to 16 years of age—At first, 5 mL two times a day with meals. Your doctor may increase your dose if needed until your blood sugar is controlled. However, the dose is usually not more than 20 mL per day. Children younger than 10 years of age—Use and dose must be determined by your doctor. For oral dosage form (tablets): Adults— Metformin alone: At first, 500 milligrams (mg) two times a day taken with the morning and evening meals, or 850 mg a day taken with the morning meal. Your doctor may increase your dose if needed until your blood sugar is controlled. Later, your doctor may want you to take 500 or 850 mg two to three times a day with meals. However, the dose is usually not more than 2550 mg per day. Metformin with a sulfonylurea: Your doctor will determine the dose of each medicine. Metformin with insulin: At first, 500 mg a day. Your doctor may increase your dose by 500 mg every week if needed until your blood sugar is controlled. However, the dose is usually not more than 2500 mg per day. Children 10 to 16 years of age—At first, 500 mg two times a day taken with the morning and evening meals. Your doctor may increase your dose if needed until your blood sugar is controlled. However, the dose is usually not more than 2000 mg per day. Children younger than 10 years of age—Use and dose must be determined by your doctor. Missed Dose

If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Precautions While Using Glucophage

It is very important that your doctor check your progress at regular visits, especially during the first few weeks that you take this medicine. Blood and urine tests may be needed to check for unwanted effects.

This medicine may interact with the dye used for an X-ray or CT scan. Your doctor should advise you to stop taking it before you have any medical exams or diagnostic tests that might cause less urine output than usual. You may be advised to start taking the medicine again 48 hours after the exams or tests if your kidney function is tested and found to be normal.

Make sure any doctor or dentist who treats you knows that you are using this medicine. You may need to stop using this medicine several days before having surgery or medical tests.

It is very important to carefully follow any instructions from your health care team about:

Alcohol—Drinking alcohol may cause severe low blood sugar. Discuss this with your health care team. Other medicines—Do not take other medicines unless they have been discussed with your doctor. This especially includes nonprescription medicines such as aspirin, and medicines for appetite control, asthma, colds, cough, hay fever, or sinus problems. Counseling—Other family members need to learn how to prevent side effects or help with side effects if they occur. Also, patients with diabetes may need special counseling about diabetes medicine dosing changes that might occur with lifestyle changes, such as changes in exercise or diet. Counseling on birth control and pregnancy may be needed because of the problems that can occur in pregnancy for patients with diabetes. Travel—Keep a recent prescription and your medical history with you. Be prepared for an emergency as you would normally. Make allowances for changing time zones and keep your meal times as close as possible to your usual meal times. In case of emergency—There may be a time when you need emergency help for a problem caused by your diabetes. You need to be prepared for these emergencies. It is a good idea to wear a medical identification (ID) bracelet or neck chain at all times. Also, carry an ID card in your wallet or purse that says that you have diabetes and a list of all of your medicines.

Under certain conditions, too much metformin can cause lactic acidosis. The symptoms of lactic acidosis are severe and quick to appear, and usually occur when other health problems not related to the medicine are present and are very severe, such as a heart attack or kidney failure. Symptoms of lactic acidosis include abdominal or stomach discomfort, decreased appetite; diarrhea; fast or shallow breathing; a general feeling of discomfort; severe muscle pain or cramping; and unusual sleepiness, tiredness, or weakness.

If symptoms of lactic acidosis occur, you should get immediate emergency medical help.

Metformin can cause low blood sugar (hypoglycemia). However, this can also occur if you delay or miss a meal or snack, drink alcohol, exercise more than usual, cannot eat because of nausea or vomiting, take certain medicines, or take metformin with another type of diabetes medicine. The symptoms of low blood sugar must be treated before they lead to unconsciousness (passing out). Different people feel different symptoms of low blood sugar. It is important that you learn which symptoms of low blood sugar you usually have so that you can treat it quickly.

Symptoms of hypoglycemia (low blood sugar) include anxiety; behavior change similar to being drunk; blurred vision; cold sweats; confusion; cool, pale skin; difficulty with thinking; drowsiness; excessive hunger; fast heartbeat; headache (continuing); nausea; nervousness; nightmares; restless sleep; shakiness; slurred speech; or unusual tiredness or weakness.

If symptoms of low blood sugar occur, eat glucose tablets or gel, corn syrup, honey, or sugar cubes; or drink fruit juice, non-diet soft drink, or sugar dissolved in water. Also, check your blood for low blood sugar. Glucagon is used in emergency situations when severe symptoms such as seizures (convulsions) or unconsciousness occur. Have a glucagon kit available, along with a syringe or needle, and know how to use it. The members of your household also should know how to use it.

High blood sugar (hyperglycemia) is another problem related to uncontrolled diabetes. Symptoms of mild high blood sugar appear more slowly than those of low blood sugar. These may include blurred vision; drowsiness; dry mouth; flushed, dry skin; fruit-like breath odor; increased urination (frequency and volume); ketones in the urine; loss of appetite; sleepiness; stomachache, nausea or vomiting; tiredness; troubled breathing (rapid and deep); unconsciousness; or unusual thirst.

High blood sugar may occur if you do not exercise as much as usual, have a fever or infection, do not take enough or skip a dose of your diabetes medicine, or overeat or do not follow your meal plan.

If symptoms of high blood sugar occur, check your blood sugar level and then call your doctor for instructions.

This medicine is only part of a complete program for controlling diabetes. It is important that you always eat a healthy diet, watch your weight, and get regular exercise.

Glucophage Side Effects

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

More common Abdominal or stomach discomfort cough or hoarseness decreased appetite diarrhea fast or shallow breathing fever or chills general feeling of discomfort lower back or side pain muscle pain or cramping painful or difficult urination sleepiness Less common Anxiety blurred vision chest discomfort cold sweats coma confusion cool, pale skin depression difficult or labored breathing dizziness fast, irregular, pounding, or racing heartbeat or pulse feeling of warmth headache increased hunger increased sweating nausea nervousness nightmares redness of the face, neck, arms, and occasionally, upper chest seizures shakiness shortness of breath slurred speech tightness in the chest unusual tiredness or weakness wheezing Rare Behavior change similar to being drunk difficulty with concentrating drowsiness lack or loss of strength restless sleep unusual sleepiness

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common Acid or sour stomach belching bloated excess air or gas in the stomach or intestines full feeling heartburn indigestion loss of appetite metallic taste in the mouth passing of gas stomachache stomach upset or pain vomiting weight loss Less common Abnormal stools bad, unusual, or unpleasant (after) taste change in taste difficulty with moving discoloration of the fingernails or toenails flu-like symptoms joint pain rash runny nose sneezing stuffy nose swollen joints

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

See also: Glucophage side effects (in more detail)

The information contained in the Thomson Reuters Micromedex products as delivered by Drugs.com is intended as an educational aid only. It is not intended as medical advice for individual conditions or treatment. It is not a substitute for a medical exam, nor does it replace the need for services provided by medical professionals. Talk to your doctor, nurse or pharmacist before taking any prescription or over the counter drugs (including any herbal medicines or supplements) or following any treatment or regimen. Only your doctor, nurse, or pharmacist can provide you with advice on what is safe and effective for you.

The use of the Thomson Reuters Healthcare products is at your sole risk. These products are provided "AS IS" and "as available" for use, without warranties of any kind, either express or implied. Thomson Reuters Healthcare and Drugs.com make no representation or warranty as to the accuracy, reliability, timeliness, usefulness or completeness of any of the information contained in the products. Additionally, THOMSON REUTERS HEALTHCARE MAKES NO REPRESENTATION OR WARRANTIES AS TO THE OPINIONS OR OTHER SERVICE OR DATA YOU MAY ACCESS, DOWNLOAD OR USE AS A RESULT OF USE OF THE THOMSON REUTERS HEALTHCARE PRODUCTS. ALL IMPLIED WARRANTIES OF MERCHANTABILITY AND FITNESS FOR A PARTICULAR PURPOSE OR USE ARE HEREBY EXCLUDED. Thomson Reuters Healthcare does not assume any responsibility or risk for your use of the Thomson Reuters Healthcare products.

More Glucophage resources Glucophage Side Effects (in more detail) Glucophage Use in Pregnancy & Breastfeeding Drug Images Glucophage Drug Interactions Glucophage Support Group 18 Reviews for Glucophage - Add your own review/rating Glucophage MedFacts Consumer Leaflet (Wolters Kluwer) Glucophage Prescribing Information (FDA) Glucophage Consumer Overview Fortamet Prescribing Information (FDA) Glucophage XR Extended-Release Tablets MedFacts Consumer Leaflet (Wolters Kluwer) Glucophage XR Prescribing Information (FDA) Glumetza Prescribing Information (FDA) Metformin Prescribing Information (FDA) Metformin Hydrochloride Monograph (AHFS DI) Riomet Prescribing Information (FDA) Riomet Consumer Overview Riomet Solution MedFacts Consumer Leaflet (Wolters Kluwer) Compare Glucophage with other medications Diabetes, Type 2 Insulin Resistance Syndrome



Pronunciation: GLOO-ka-gon



Generic Name: sermorelin (Injection route)

ser-moe-REL-in

Commonly used brand name(s)

In the U.S.

Geref Geref Diagnostic

Available Dosage Forms:

Powder for Solution

Therapeutic Class: Endocrine-Metabolic Agent

Pharmacologic Class: Growth Hormone Releasing Hormone Analog

Uses For Geref Diagnostic

Sermorelin is a synthetic (man-made) version of a naturally occurring substance that causes release of growth hormone from the pituitary gland. Growth hormone is naturally produced by the pituitary gland and is necessary for growth in children. In children who fail to grow normally because their bodies are not producing enough growth hormone, this medicine may be used to increase the amount of growth hormone produced by the pituitary gland.

This medicine is available only with your doctor's prescription.

Before Using Geref Diagnostic

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pregnancy Pregnancy Category Explanation All Trimesters C Animal studies have shown an adverse effect and there are no adequate studies in pregnant women OR no animal studies have been conducted and there are no adequate studies in pregnant women. Breast Feeding

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Interactions with Medicines

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. Tell your healthcare professional if you are taking any other prescription or nonprescription (over-the-counter [OTC]) medicine.

Interactions with Food/Tobacco/Alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other Medical Problems

The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

Underactive thyroid—This condition can interfere with the effects of sermorelin Proper Use of sermorelin

This section provides information on the proper use of a number of products that contain sermorelin. It may not be specific to Geref Diagnostic. Please read with care.

If you are injecting this medicine yourself, use it exactly as directed by your doctor. Do not use more or less of it, and do not use it more often than your doctor ordered. The exact amount of medicine needed has been carefully worked out. Using too much will increase the risk of side effects, while using too little may not improve the condition.

Each package of sermorelin contains a patient instruction sheet. Read this sheet carefully and make sure you understand:

How to prepare the injection. Proper use of disposable syringes and needles, including safe handling and disposal. How to give the injection. How long the injection is safe to use.

It is best to use a different place on the body for each injection (for example, abdomen, hip, thigh, or upper arm). To help you remember to do this, you may want to keep a record of the date and location for each injection.

Dosing

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

Storage

Store in the refrigerator. Do not freeze.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Precautions While Using Geref Diagnostic

It is very important that your doctor check your progress at regular visits.

Geref Diagnostic Side Effects

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

More common Pain, redness, or swelling at the place of injection Rare Itching trouble in swallowing

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

Rare Dizziness flushing headache sleepiness trouble sitting still

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

The information contained in the Thomson Reuters Micromedex products as delivered by Drugs.com is intended as an educational aid only. It is not intended as medical advice for individual conditions or treatment. It is not a substitute for a medical exam, nor does it replace the need for services provided by medical professionals. Talk to your doctor, nurse or pharmacist before taking any prescription or over the counter drugs (including any herbal medicines or supplements) or following any treatment or regimen. Only your doctor, nurse, or pharmacist can provide you with advice on what is safe and effective for you.

The use of the Thomson Reuters Healthcare products is at your sole risk. These products are provided "AS IS" and "as available" for use, without warranties of any kind, either express or implied. Thomson Reuters Healthcare and Drugs.com make no representation or warranty as to the accuracy, reliability, timeliness, usefulness or completeness of any of the information contained in the products. Additionally, THOMSON REUTERS HEALTHCARE MAKES NO REPRESENTATION OR WARRANTIES AS TO THE OPINIONS OR OTHER SERVICE OR DATA YOU MAY ACCESS, DOWNLOAD OR USE AS A RESULT OF USE OF THE THOMSON REUTERS HEALTHCARE PRODUCTS. ALL IMPLIED WARRANTIES OF MERCHANTABILITY AND FITNESS FOR A PARTICULAR PURPOSE OR USE ARE HEREBY EXCLUDED. Thomson Reuters Healthcare does not assume any responsibility or risk for your use of the Thomson Reuters Healthcare products.

More Geref Diagnostic resources Geref Diagnostic Use in Pregnancy & Breastfeeding Geref Diagnostic Support Group 0 Reviews · Be the first to review/rate this drug Geref MedFacts Consumer Leaflet (Wolters Kluwer)



Generic Name: follicle stimulating hormone (FOL ik al STIM ue lay ting HOR mone)



Gyno-Pevaryl 1 vaginal pessary

Econazole nitrate

Gyno-Pevaryl is a registered trademark

Read all of this leaflet carefully before you start using this medicine. Keep this leaflet. You may need to read it again If you have any further questions, ask your doctor or pharmacist This medicine has been prescribed for you. Do not pass it on to others. It may harm them, even if their symptoms are the same as yours If you get side effects and they become serious or if you notice any side effects not listed in this leaflet, please tell your doctor or pharmacist In this leaflet 1. What Gyno-Pevaryl 1 is and what it is used for 2. Before you use Gyno-Pevaryl 1 3. How to use Gyno-Pevaryl 1 4. Possible side effects 5. How to store Gyno-Pevaryl 1 6. Further information What Gyno-Pevaryl 1 is and what it is used for

The name of your medicine is Gyno-Pevaryl 1 vaginal pessary. It is called ‘Gyno-Pevaryl 1’ in this leaflet.

Gyno-Pevaryl 1 is a solid, bullet-shaped pessary (vaginal suppository). When inserted into the vagina it releases a medicine called econazole. This belongs to a group of medicines called ‘antifungals’.

Gyno-Pevaryl 1 is used for infections of the vagina and the skin around the vagina. The infections are caused by fungi and yeasts such as thrush (Candida).

Before you use Gyno-Pevaryl 1 Do not use Gyno-Pevaryl 1 if: You are allergic to anything in Gyno-Pevaryl 1 (listed in section 6 below) You are allergic to any other medicine used to treat thrush or other fungal infections You are under 16 years old

Do not use this medicine if any of the above apply to you. If you are not sure, talk to your doctor or pharmacist before using Gyno-Pevaryl 1.

Take special care with Gyno-Pevaryl 1

Check with your doctor or pharmacist before using this medicine if:

You are using a ‘barrier’ method of contraception. This includes condoms or diaphragms. This is because Gyno-Pevaryl 1 can damage the rubber and stop them working properly. Talk to your doctor about using another type of contraception while you are using this medicine Taking other medicines

Please tell your doctor or pharmacist if you are taking or have recently taken any other medicines. This includes medicines that you buy without a prescription or herbal medicines.

In particular tell your doctor if you are taking:

Medicines to thin the blood (anticoagulants) such as warfarin or acenocoumarol Pregnancy and breast-feeding

Please tell your doctor before using Gyno-Pevaryl 1 if you are pregnant, think you may be pregnant or might become pregnant.

You may still be able to use Gyno-Pevaryl 1 if your doctor thinks you need to.

Ask your doctor or pharmacist for advice before taking any medicine if you are pregnant or breast-feeding.

Driving and using machines

This medicine is not likely to affect you being able to drive or use any tools or machines.

How to use Gyno-Pevaryl 1

Always use this medicine exactly as your doctor has told you. You should check with your doctor or pharmacist if you are not sure.

Using the pessary Use the pessary just before going to bed. This helps it to stay in place Do not swallow the pessary Inserting the pessary with the applicator Remove the pessary from the plastic packet using the easy open tab Pull the plunger of the applicator out until it sticks Gently push the pessary into the cup. Do not force it because it might stick Lie down with your knees bent and spread apart. Insert the applicator high into your vagina, pessary first Push the plunger to release the pessary Remove the applicator and dispose of it safely in your household waste If you swallow Gyno-Pevaryl 1

If the pessary is eaten or swallowed talk to a doctor or go to the nearest hospital casualty department straight away.

If you have any further questions on the use of this product, ask your doctor or pharmacist.

Possible side effects

Like all medicines, Gyno-Pevaryl 1 can cause side effects, although not everybody gets them.

Stop using Gyno-Pevaryl 1 and tell your doctor straight away if you notice the following. You may need urgent medical treatment. Sudden swelling of the face or throat. Hives (also known as nettle rash or urticaria), severe irritation, reddening or blistering of your skin. These may be signs of a severe allergic reaction (affects less than 1 in 10,000 people) Other side effects: Itchy and red skin around or inside the vagina. This is much milder than an allergic reaction. Tell your doctor or pharmacist if this feeling lasts for more than a few minutes or gets worse (rash, burning or swelling)

If you get side effects and they become serious or if you notice any other side effects not listed in this leaflet, please tell your doctor or pharmacist.

How to store Gyno-Pevaryl 1

Keep out of the reach and sight of children. Store in the original container. Do not store above 30°C. Keep away from heat and sunlight.

Do not use Gyno-Pevaryl 1: After the expiry date which is stated on the label. The expiry date refers to the last day of that month If the plastic packet is broken or missing If the pessary is not light beige in colour

Medicines should not be disposed of via wastewater or household waste. Ask your pharmacist how to dispose of medicines no longer required. These measures will help protect the environment.

Further information

The active substance in Gyno-Pevaryl 1 is econazole nitrate. The pessary contains 150mg econazole nitrate.

The other ingredients are polygel, colloidal silicon dioxide, Witepsol H 19, Wecobee FS, stearyl heptanoate.

What Gyno-Pevaryl 1 looks like and contents of the pack

Gyno-Pevaryl 1 comes in a plastic strip containing one pessary. It is bullet-shaped and light beige in colour.

The product licence is held by: JANSSEN-CILAG LTD 50-100 Holmers Farm Way High Wycombe Bucks HP12 4EG UK Gyno-Pevaryl 1 is made by: Janssen Pharmaceutica NV Turnhoutseweg 30 B-2340 Beerse Belgium

OR

McGregor Cory Ltd Middleton Close Banbury Oxfordshire OX16 8RS UK

For information in large print, tape, CD or Braille, telephone 0800 7318450.

This leaflet was last approved in August 2008.



A drug may be classified by the chemical type of the active ingredient or by the way it is used to treat a particular condition. Each drug can be classified into one or more drug classes.

Gonadotropins are hormones synthesized and released by the anterior pituitary, and act on the gonads (testes and ovaries) to promote production of sex hormones and stimulate production of either sperm or ova. Follicle stimulating hormone (FSH) and luteinizing hormones (LH) are the main gonadotropins. Human chorionic gonadotropin is a gonadotropin that is only produced during pregnancy by the placenta.

Gonadotropin production is controlled by gonadotropin-releasing hormone, which is released by the hypothalamus. The effects of gonadotrophins differ in males and females.

Gonadotropins are used in fertility treatment to produce mature follicles and ovulation induction, in women. In men, it is used to increase sperm count as part of fertility treatment.

See also

Medical conditions associated with gonadotropins:

Female Infertility Follicle Stimulation Hypogonadism, Male Obesity Ovulation Induction Prepubertal Cryptorchidism Drug List: Gonal-F-Powder Ovidrel Pregnyl Hcg Novarel Bravelle Chorex Chorionic-Gonadotropin Fertinex Follistim Follistim-Antagon-Injectable-Kit Follistim-Aq Follistim-Aq-Cartridge Gonal-F-Rff Gonal-F-Rff-Pen-Solution Luveris Menopur Metrodin Profasi Profasi-Hp Repronex



Pronunciation: goe-nad-oh-RELL-in



Pronunciation: ga-ti-FLOKS-a-sin



1. Name Of The Medicinal Product

GYGEL Contraceptive Jelly

2. Qualitative And Quantitative Composition

The gel contains 2.0% w/w of nonoxinol-9.

3. Pharmaceutical Form

Vaginal gel.

4. Clinical Particulars 4.1 Therapeutic Indications

For use as a spermicidal contraceptive in conjunction with barrier methods of contraception.

4.2 Posology And Method Of Administration

Method of Administration

For vaginal use.

For use by adult females only.

Posology

The gel should be spread over the surface of the diaphragm which will be in contact with the cervix, and on the rim. The diaphragm and spermicide must be allowed to remain undisturbed for at least six to eight hours after coitus. A fresh application of gel or other spermicides, must be made prior to any subsequent acts of coitus within this period of time, without removing the diaphragm. (A vaginal applicator should be used for inserting more jelly.)

Douching is not recommended, but if desired it should be deferred for at least six hours after intercourse.

4.3 Contraindications

Hypersensitivity to nonoxinol-9 or to any component of the preparation.

Patients with absent vaginal sensation e.g. paraplegics and quadriplegics.

4.4 Special Warnings And Precautions For Use

Spermicidal intravaginal preparations are intended for use in conjunction with barrier methods of contraception such as condoms, diaphragms and caps.

Where avoidance of pregnancy is important, the choice of contraceptive method should be made in consultation with a doctor or a family planning clinic.

This product does not protect against HIV (AIDS) or other sexually transmitted diseases (STDs). A latex condom should be used to protect against the spread of STDs. High frequency use of nonoxinol-9 has been reported to cause epithelial damage and increase the risk of HIV infection. Therefore women at risk of HIV/STD infection and who have multiple daily acts of intercourse should be advised to choose another method of contraception. Sexually active women should consider their individual HIV/STD infection risk when choosing a method of contraception.

If vaginal or penile irritation occurs, discontinue use. If symptoms worsen or continue for more than 48 hours, medical advice should be sought.

4.5 Interaction With Other Medicinal Products And Other Forms Of Interaction

None known.

4.6 Pregnancy And Lactation

There is no evidence from animal and human studies that nonoxinol-9 is teratogenic. Human epidemiological studies have not shown any firm evidence of adverse effects on the foetus, however some studies have shown that nonoxinol-9 may be embryotoxic in animals. This product should not be used if pregnancy is suspected or confirmed. Animal studies have detected nonoxinol-9 in milk after intravaginal administration. Use by lactating women has not been studied.

4.7 Effects On Ability To Drive And Use Machines

None known.

4.8 Undesirable Effects

Nonoxinol-9 has been reported to cause epithelial damage and increase the risk of HIV infection.

It may cause hypersensitivity and application site reactions such as irritation, pain, discomfort, burning sensation, itching, dryness, rash and redness of the vulva, vagina or penis.

4.9 Overdose

If taken orally, the surfactant properties of this preparation may cause gastric irritation. General supportive therapy should be carried out. Hepatic and renal function should be monitored if medically indicated.

5. Pharmacological Properties 5.1 Pharmacodynamic Properties

The standard in vitro test (Sander-Cramer) evaluating the effect of nonoxinol-9 on animal sperm motility has shown the compound to be a potent spermicide.

The site of action of nonoxinol-9 has been determined as the sperm cell membrane. The lipoprotein membrane is disrupted, increasing permeability, with subsequent loss of cell components and decreased motility. A similar effect on vaginal epithelial and bacterial cells is also found.

5.2 Pharmacokinetic Properties

The intravaginal absorption and excretion of radiolabelled (14C) nonoxinol-9 has been studied in non-pregnant rats and rabbits and in pregnant rats. No appreciable difference was found in the extent or rate of absorption in pregnant and non-pregnant animals. Plasma levels peaked at about one hour and recovery from urine as unchanged nonoxinol-9 accounted for approximately 15-25% and faeces approximately 70% of the administered dose as unchanged nonoxinol-9. Less than 0.3% was found in the milk of lactating rats. No metabolites were detected in any of the samples analysed.

5.3 Preclinical Safety Data

No relevant information additional to that contained elsewhere in the Summary of Product Characteristics.

6. Pharmaceutical Particulars 6.1 List Of Excipients

Methyl parahydroxybenzoate (E 218)

Sorbitol solution (E 420)

Lactic acid

Povidone K30

Propylene glycol

Sodium carboxymethylcellulose

Sorbic acid (E 200)

Purified water

6.2 Incompatibilities

Not applicable.

6.3 Shelf Life

2 years.

6.4 Special Precautions For Storage

Do not store above 25?C.

6.5 Nature And Contents Of Container

Epoxy resin lined aluminium tubes with polyethylene caps. Available in 30 and 81 gram packs; an applicator is available separately if required.

6.6 Special Precautions For Disposal And Other Handling

Not applicable.

Administrative Data 7. Marketing Authorisation Holder

Marlborough Pharmaceuticals Ltd

35A High Street

Marlborough

Wilts

SN8 1LW

UK

8. Marketing Authorisation Number(S)

PL 23138/0010

9. Date Of First Authorisation/Renewal Of The Authorisation

12 September 1995/17 July 1996

10. Date Of Revision Of The Text

9th September 2009

11 LEGAL CATEGORY

GSL



drospirenone and ethinyl estradiol



1. Name Of The Medicinal Product

GLYCERYL TRINITRATE TABLETS BP 500 micrograms

2. Qualitative And Quantitative Composition

Each tablet contains 500 micrograms Glyceryl Trinitrate BP.

3. Pharmaceutical Form

White uncoated tablets.

White, circular, biconvex uncoated tablets, impressed “C” on one face and the identifying letters “GF” on the reverse.

4. Clinical Particulars 4.1 Therapeutic Indications

As a short-acting vasodilator

Relief of angina pectoris

Prophylaxis of angina pectoris

Relief of acute spontaneous coronary artery spasm

4.2 Posology And Method Of Administration

Posology

1-2 tablets (0.5-1.0mg) should be placed under the tongue and allowed to dissolve slowly; this dose should be repeated as required. If pain persists after a total of 3 doses in 15minutes the patient should be advised to seek medical attention.

Dosage should be adjusted according to the response obtained by the individual patient and the severity of the anginal pain.

NB Tolerance may develop with daily use, but withdrawal for a week re-establishes the original sensitivity.

Method of Administration

For sublingual administration

4.3 Contraindications

Known hypersensitivity to nitrates and other ingredients in the tablets. Patients with rare hereditary problems of galactose intolerence, the Lapp lactase deficiency or glucose-galactose malabsorption should not take this medicine.

Marked anaemia, raised intercranial pressure including that caused by head trauma, cerebral haemorrhage, closed angle glaucoma, hypotensive conditions, hypovolaemia, obstructive hypertrophic cardiomyopathy, aortic stenosis, mitral stenosis, cardiac tamponade, obstructive heart failure and constrictive pericarditis.

Phosphodiesterase type-5 inhibitors (eg sildenafil, tadalafil, vardenafil) have been shown to potentiate the hypotensive effects of nitrates, and its co-administration with nitrates, and their co-administration with nitrates or nitric oxide donors is therefore contra-indicated.

4.4 Special Warnings And Precautions For Use

Caution is necessary in patients with severe hepatic or renal impairment, hypothyroidism, hypoxaemia, hypothermia or a recent history of myocardial infaraction and malnutrition.

4.5 Interaction With Other Medicinal Products And Other Forms Of Interaction

Some effects of glyceryl trinitrate are enhanced by alcohol. The hypotensive effects of nitrates are potentiated by concurrent administration of phosphodiestrase type-5 inhibitors (eg sildenafil, tadalafil, vardenafil).

Glyceryl trinitrate may potentiate the effects of anti-hypertensive drugs (such as vasodilators, beta-blockers, calcium-channel blockers, diuretics).

There is a potential for drugs that cause dry mouth (eg anticholinergic, antimuscarinics, tricyclic antidepressants) to reduce the effectiveness of sublingual nitrates.

There have been some reports that the anticoagulant effects of heparin may be reduced by the concurrent use of nitrates. The effects of heparin should be monitored and dose adjusted as necessary.

An enhanced hypotensive effect with sublingual apomorphine may occur as a result of concomitant administration with glyceryl trinitrate.

Ergot alkaloids may oppose the coronary vasodilatation of nitrates. Ergot alkaloids can precipitate angina and glyceryl trinitrate can reduce the first pass hepatic metabolism of dihydroergotamine.

4.6 Pregnancy And Lactation

There is no, or inadequate, evidence of safety of nitrates in human pregnancy or lactation; nitrates should not be administered in pregnancy or lactation unless considered essential.

4.7 Effects On Ability To Drive And Use Machines

As Glyceryl trinitrate can cause dizziness patients should make sure they are not affected before driving or operating machinery. This effect appears to be accentuated by alcohol.

4.8 Undesirable Effects

System Organ Class

Very Common

(

Common

(

Uncommon

(

Rare

(

Very Rare

(< 1/10,00)

Frequency not known (cannot be estimated from the available data)

Nervous system disorders

Throbbing headache

Vertigo

       

Eye disorders

         

Increased ocular pressure

Cardiac disorders

     

Tachycardia, bradycardia

 

Syncope, hypoxaemia

Vascular disorders

 

Dizziness

 

Postural hypotension

   

Gastrointestinal disorders

 

Nausea

     

vomiting

Skin and subcutaneous tissue disorders

 

Facial flushing

 

Allergic skin reactions

Exfoliative dermatitis

 

General disorders and administration site complications

 

Weakness

Localised burning sensation

      4.9 Overdose

Toxic effects of glyceryl trinitrate include vomiting, restlessness, hypotension, syncope, cyanosis and methaemoglobinaemia; impairment of respiration, hypoxia, bradycardia and psychosis may ensue.

Overdosage should be treated with gastric lavage, followed by charcoal administration if necessary in case that nitrates were ingested, attention to any respiratory and circulatory symptoms. Oxygen may prove additionally useful.

Effects of hypotension may be minimised by treating the patient in the recumbent position with the head lowered or raised legs. Methaemoglobinaemia may be treated with methylene blue intravenously 1-4mg/kg body-weight. The circulation may be maintained with infusions of plasma or suitable electrolyte solutions.

5. Pharmacological Properties 5.1 Pharmacodynamic Properties

ATC Code: CO1D AO2 Organic nitrates

Glyceryl trinitrate is a vasodilator and is used for angina of effort. Vasodilation is achieved by the releasing of free redical nitric oxide which activates guanylate cyclase and increases synthesis of guanosine 3? and 5?-monophosphate with resultant effects on the phosphorylation of proteins in smooth muscle. If taken in excess, its vasodilatory effect can cause headache.

5.2 Pharmacokinetic Properties

Glyceryl trinitrate is readily absorbed from the oral mucosa, but rapidly metabolised so that it only has a fleeting duration of action.

Glyceryl trinitrate is also readily absorbed from the gastrointestinal tract, but owing to extensive first-pass metabolism in the liver its bioavailability is reduced (short plasma half-life).

Glyceryl trinitrate is metabolised by hydrolysis to dinitrates and the mononitrate, which is the main urinary metabolite.

5.3 Preclinical Safety Data

There are no pre-clinical data of relevance to the prescriber which are additional to that already included in other sections of the SPC.

6. Pharmaceutical Particulars 6.1 List Of Excipients

The tablets also contain: lactose, stearic acid, magnesium stearate, colloidal silicon dioxide, mannitol, acacia.

6.2 Incompatibilities

None known.

6.3 Shelf Life

Shelf-life

Two years from the date of manufacture.

Shelf-life after dilution/reconstitution

Not applicable.

Shelf-life after first opening

Discard 8 weeks after first opening.

6.4 Special Precautions For Storage

Store below 25°C in a dry place.

Protect from light.

6.5 Nature And Contents Of Container

The product is supplied in amber glass bottles with screw caps lined with aluminium foil.

Pack sizes: 56s, 60s, 84s, 90s, 100s, 112s, 120s, 168s, 180s, 200s, 1000s

Product may also be supplied in bulk packs, for reassembly purposes only, in amber glass containers with screw caps lined with aluminium foil, filled with aluminium foil as a cushioning material.

Maximum size of bulk packs: 5,000

6.6 Special Precautions For Disposal And Other Handling

• Your Glyceryl Trinitrate tablets will be presented in a glass airtight container with a foil-lined cap. Keep them in this.

• After use reclose the bottle cap tightly.

• Do not put cotton wool, other drugs, or anything else in the bottle with the tablets.

• Store the tablets below 25oC in a dry place, protected from light. If you need to carry them with you DO NOT carry them close to your body, rather in a purse, wallet or handbag.

If you do not use the tablets within 8 weeks of first opening the bottle, obtain a fresh supply and return the old tablets to your pharmacist. (A fresh tablet should produce a slight burning sensation when placed under the tongue; if this does not occur, obtain a fresh supply). In any event do not use the tablets after the expiry date shown.

Administrative Data 7. Marketing Authorisation Holder

Actavis UK Limited

(Trading style: Actavis)

Whiddon Valley

BARNSTAPLE

N Devon EX32 8NS

8. Marketing Authorisation Number(S)

PL 0142/6296 R

9. Date Of First Authorisation/Renewal Of The Authorisation

February 1986

January 1994, June 1999

10. Date Of Revision Of The Text

16/04/2010





Pronunciation: GRIS-ee-oh-FUL-vin



Generic Name: gonadorelin (injectable) (gon ah doe REH lin)



Generic Name: Gentamicin Sulfate eent



Pronunciation: glye-MEP-ir-ide/ROE-si-GLI-ta-zone



gla-TIR-a-mer AS-e-tate

Commonly used brand name(s)

In the U.S.

Copaxone

Available Dosage Forms:

Solution Powder for Solution Kit

Therapeutic Class: Central Nervous System Agent

Uses For glatiramer

Glatiramer injection is used to reduce the frequency of relapses (flare-ups) in patients with relapsing-remitting multiple sclerosis (RMMS). glatiramer will not cure multiple sclerosis (MS), but may extend the time between relapses.

glatiramer is available only with your doctor's prescription.

Before Using glatiramer

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For glatiramer, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to glatiramer or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Appropriate studies have not been performed on the relationship of age to the effects of glatiramer injection in the pediatric population. Safety and efficacy have not been established.

Geriatric

Appropriate studies on the relationship of age to the effects of glatiramer injection have not been performed in the geriatric population. However, no geriatric-specific problems have been documented to date.

Pregnancy Pregnancy Category Explanation All Trimesters B Animal studies have revealed no evidence of harm to the fetus, however, there are no adequate studies in pregnant women OR animal studies have shown an adverse effect, but adequate studies in pregnant women have failed to demonstrate a risk to the fetus. Breast Feeding

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Interactions with Medicines

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. Tell your healthcare professional if you are taking any other prescription or nonprescription (over-the-counter [OTC]) medicine.

Interactions with Food/Tobacco/Alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other Medical Problems

The presence of other medical problems may affect the use of glatiramer. Make sure you tell your doctor if you have any other medical problems, especially:

Infection—May decrease your ability to fight infections. Proper Use of glatiramer

Use glatiramer exactly as directed by your doctor in order to help your condition as much as possible.

Special patient directions come with glatiramer injection. Read the directions carefully before using the medicine.

To use the injection:

Before you self-inject the glatiramer dose, decide where you will inject yourself. There are seven possible injection sites on your body (e.g., arms, thighs, hips, or lower abdomen or stomach area), and you should not use any site more than once each week. Marking a calendar will help you keep track of the sites you have used each day. Try to be consistent and give yourself the injection at the same time each day. Choose a time when you feel strongest. Also, do not inject the medicine in a part of the skin that is depressed.

First, gather the items you will need on a clean cloth or towel in a well-lighted area. Wash your hands with soap and water. Do not touch your hair or skin afterwards. Remove one prefilled syringe from the carton in the refrigerator. Take the syringe out of the protective wrapper. Allow 20 minutes for the syringe to warm up to room temperature before injecting the medicine. Check the liquid in the prefilled syringe to see if it is cloudy or contains any particles. If the liquid is cloudy, do not use the syringe. Call the company at 1-800-887-8100 for help. Take out another syringe and follow the same steps for warming. If the liquid in the syringe is clear, place it on the clean, flat surface and wait for it to warm to room temperature. Choose an injection site on your body. Clean the injection site with a fresh alcohol wipe, and let it dry. Pick up the 1-milliliter prefilled syringe and hold it as you would a pencil, using the hand you write with. Remove the plastic cover from the needle, but do not touch the needle itself. Pinch about a 2-inch fold of skin between your thumb and index finger. Insert the needle into the 2-inch fold of skin. It may help to steady your hand by resting the heel of your hand against your body. When the needle is all the way in, release the fold of skin. Inject the medicine by holding the syringe steady while pushing down on the plunger. The injection should take just a few seconds. Pull the needle straight out. Press a dry clean cotton ball on the injection site for a few seconds, but do not massage it. Put the plastic cover back on the needle.

To dispose of the needles and syringes:

Needles and syringes should be used for only one injection. Place all used syringes and needles in a hard-walled plastic container, such as a liquid laundry detergent container. Keep the cover of this container tight and out of the reach of children. When the container is full, check with your physician or nurse about proper disposal, as laws vary from state to state.

Dosing

The dose of glatiramer will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of glatiramer. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

For injection dosage form: For multiple sclerosis (MS): Adults—20 milligrams (mg) injected under the skin once a day. Children—Use and dose must be determined by your doctor. Missed Dose

If you miss a dose of glatiramer, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Store in the refrigerator. Do not freeze.

You may also store glatiramer injection at room temperature for up to one month. Avoid exposing glatiramer to bright or intense light.

Precautions While Using glatiramer

It is very important that your doctor check your progress at regular visits to make sure that glatiramer is working properly and to check for unwanted effects.

Some patients have a reaction to glatiramer a few minutes after receiving a shot. The symptoms might include: chest pain; flushing; a fast, irregular, or pounding heartbeat; anxiety; trouble with breathing; a tight feeling in the throat; or hives. These symptoms will usually go away without treatment in a short time. Call your doctor right away if these symptoms become worse or do not go away. This reaction can happen even if you have used the medicine regularly for several months. Also, chest pain can occur by itself, but should not last more than a few minutes.

glatiramer may cause a permanent depression under the skin at the injection site. Contact your doctor right away if you notice any of these side effects at the injection site: depressed or indented skin; blue-green to black skin discoloration; or pain, redness, or sloughing (peeling) of the skin.

Do not stop using glatiramer without first checking with your doctor.

glatiramer Side Effects

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

More common Anxiety bleeding, hard lump, hives or welts, itching, pain, redness, or swelling at the place of injection chest pain cough excessive muscle tone fast, irregular, pounding, or racing heartbeat or pulse flushing joint pain lower back or side pain neck pain painful or difficult urination skin rash swelling or puffiness of the face swollen lymph glands swollen, painful, or tender lymph glands in the neck, armpit, or groin troubled breathing Less common Agitation bloating or swelling chills confusion difficulty with swallowing fainting fever headache, severe and throbbing itching of the vagina or outside genitals muscle aches pain pain during sexual intercourse purple spots under the skin rapid weight gain red streaks on the skin shakiness in the legs, arms, hands, or feet small lumps under the skin spasm of the throat strong urge to urinate swelling of the fingers, arms, feet, or legs swelling or puffiness of the face thick, white curd-like vaginal discharge without odor or with mild odor tightness in the chest or wheezing tingling of the hands or feet trembling or shaking of the hands or feet unusual weight gain or loss Rare Back pain blood in the urine burning or stinging of the skin continuous, uncontrolled back-and-forth or rolling eye movements decreased sexual ability diarrhea difficulty with moving ear pain fast breathing high blood pressure irritation of the mouth and tongue (thrush) loss of appetite menstrual pain or changes muscle pain painful cold sores or blisters on the lips, nose, eyes, or genitals sensation of motion, usually whirling, either of oneself or of one's surroundings speech problems vision problems

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common Increased sweating lack or loss of strength nausea unusual tiredness or weakness vomiting Less common Double vision runny nose seeing double weight gain

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

See also: glatiramer Subcutaneous side effects (in more detail)

The information contained in the Thomson Reuters Micromedex products as delivered by Drugs.com is intended as an educational aid only. It is not intended as medical advice for individual conditions or treatment. It is not a substitute for a medical exam, nor does it replace the need for services provided by medical professionals. Talk to your doctor, nurse or pharmacist before taking any prescription or over the counter drugs (including any herbal medicines or supplements) or following any treatment or regimen. Only your doctor, nurse, or pharmacist can provide you with advice on what is safe and effective for you.

The use of the Thomson Reuters Healthcare products is at your sole risk. These products are provided "AS IS" and "as available" for use, without warranties of any kind, either express or implied. Thomson Reuters Healthcare and Drugs.com make no representation or warranty as to the accuracy, reliability, timeliness, usefulness or completeness of any of the information contained in the products. Additionally, THOMSON REUTERS HEALTHCARE MAKES NO REPRESENTATION OR WARRANTIES AS TO THE OPINIONS OR OTHER SERVICE OR DATA YOU MAY ACCESS, DOWNLOAD OR USE AS A RESULT OF USE OF THE THOMSON REUTERS HEALTHCARE PRODUCTS. ALL IMPLIED WARRANTIES OF MERCHANTABILITY AND FITNESS FOR A PARTICULAR PURPOSE OR USE ARE HEREBY EXCLUDED. Thomson Reuters Healthcare does not assume any responsibility or risk for your use of the Thomson Reuters Healthcare products.

More glatiramer Subcutaneous resources Glatiramer Subcutaneous Side Effects (in more detail) Glatiramer Subcutaneous Use in Pregnancy & Breastfeeding Glatiramer Subcutaneous Drug Interactions Glatiramer Subcutaneous Support Group 29 Reviews for Glatiramer Subcutaneous - Add your own review/rating Compare glatiramer Subcutaneous with other medications Multiple Sclerosis



Generic Name: glipizide (Oral route)

GLIP-i-zide

Commonly used brand name(s)

In the U.S.

Glucotrol Glucotrol XL

Available Dosage Forms:

Tablet, Extended Release Tablet

Therapeutic Class: Hypoglycemic

Chemical Class: 2nd Generation Sulfonylurea

Uses For Glucotrol XL

Glipizide is used to treat high blood sugar levels caused by a type of diabetes mellitus (sugar diabetes) called type 2 diabetes. In type 2 diabetes, your body does not work properly to store excess sugar and the sugar remains in your bloodstream. Chronic high blood sugar can lead to serious health problems in the future.

Proper diet is the first step in managing type 2 diabetes, but often medicines are needed to help your body. Glipizide belongs to a class of drugs called sulfonylureas. It stimulates the release of insulin from the pancreas, directing your body to store blood sugar. This helps lower blood sugar and restore the way you use food to make energy.

This medicine is available only with your doctor's prescription.

Before Using Glucotrol XL

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Appropriate studies have not been performed on the relationship of age to the effects of glipizide in the pediatric population. Safety and efficacy have not been established.

Geriatric

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of glipizide in the elderly. However, elderly patients are more likely to have age-related heart, liver, or kidney problems which may require caution in patients receiving glipizide.

Pregnancy Pregnancy Category Explanation All Trimesters C Animal studies have shown an adverse effect and there are no adequate studies in pregnant women OR no animal studies have been conducted and there are no adequate studies in pregnant women. Breast Feeding

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Interactions with Medicines

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

Acarbose Alatrofloxacin Balofloxacin Ciprofloxacin Clinafloxacin Disopyramide Enoxacin Fleroxacin Flumequine Gatifloxacin Gemifloxacin Grepafloxacin Levofloxacin Lomefloxacin Moxifloxacin Norfloxacin Ofloxacin Pefloxacin Prulifloxacin Rufloxacin Sparfloxacin Temafloxacin Tosufloxacin Trovafloxacin Mesylate

Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

Acebutolol Aceclofenac Acemetacin Alclofenac Alprenolol Apazone Atenolol Benoxaprofen Betaxolol Bevantolol Bisoprolol Bitter Melon Bromfenac Bucindolol Bufexamac Carprofen Carteolol Carvedilol Celiprolol Cimetidine Clarithromycin Clometacin Clonixin Clorgyline Cyclosporine Dexketoprofen Diazoxide Diclofenac Diflunisal Dilevalol Dipyrone Droxicam Esmolol Etodolac Etofenamate Felbinac Fenbufen Fenoprofen Fentiazac Fenugreek Floctafenine Flufenamic Acid Flurbiprofen Glucomannan Hydrochlorothiazide Ibuprofen Indomethacin Indoprofen Iproniazid Isocarboxazid Isoxicam Ketoprofen Ketorolac Labetalol Levobunolol Lornoxicam Meclofenamate Mefenamic Acid Meloxicam Mepindolol Metipranolol Metoprolol Moclobemide Nabumetone Nadolol Naproxen Nebivolol Nialamide Niflumic Acid Nimesulide Oxaprozin Oxprenolol Oxyphenbutazone Pargyline Penbutolol Phenelzine Phenylbutazone Pindolol Pirazolac Piroxicam Pirprofen Procarbazine Propranolol Propyphenazone Proquazone Psyllium Ranitidine Selegiline Sotalol Sulfadiazine Sulfamethoxazole Sulindac Suprofen Talinolol Tenidap Tenoxicam Tertatolol Tiaprofenic Acid Timolol Tolmetin Toloxatone Tranylcypromine Voriconazole Zomepirac Interactions with Food/Tobacco/Alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following is usually not recommended, but may be unavoidable in some cases. If used together, your doctor may change the dose or how often you use this medicine, or give you special instructions about the use of food, alcohol, or tobacco.

Ethanol Other Medical Problems

The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

Alcohol intoxication or Underactive adrenal glands or Underactive pituitary gland or Undernourished condition or Weakened physical condition or Any other condition that causes low blood sugar—Patients with these conditions may be more likely to develop low blood sugar while taking glipizide. Diabetic ketoacidosis (ketones in the blood) or Type I diabetes—Should not be used in patients with these conditions. Fever or Infection or Surgery or Trauma—These conditions may cause temporary problems with blood sugar control and your doctor may want to treat you temporarily with insulin. Glucose 6-phosphate dehydrogenase (G6PD) deficiency (an enzyme problem)—May cause hemolytic anemia (blood disorder) in patients with this condition. Heart or blood vessel disease—Use with caution. May make this condition worse. Kidney disease or Liver disease—Higher blood levels of this medicine may occur, which may cause serious problems. Narrowed or blocked food passages (e.g., esophagus, stomach, or intestines), severe—Use with caution. The extended-release tablet may cause obstruction in patients with this condition. Proper Use of glipizide

This section provides information on the proper use of a number of products that contain glipizide. It may not be specific to Glucotrol XL. Please read with care.

Follow carefully the special meal plan your doctor gave you. This is the most important part of controlling your condition, and is necessary if the medicine is to work properly. Also, exercise regularly and test for sugar in your blood or urine as directed.

This medicine comes with a patient information insert. Read and follow the instructions in the insert carefully. Ask your doctor if you have any questions.

Swallow the extended release tablet whole. Do not split, crush, or chew it.

If you are taking the extended release tablet, part of the tablet may pass into your stool after your body has absorbed the medicine. This is normal and nothing to worry about.

Dosing

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

For type 2 diabetes: For oral dosage form (extended-release tablets): Adults—At first, 5 milligrams (mg) once a day taken with breakfast. Your doctor may adjust your dose if needed. The dose is usually not more than 20 mg per day. Children—Use and dose must be determined by your doctor. For oral dosage form (tablets): Adults—At first, 5 milligrams (mg) once a day taken at least 30 minutes before breakfast. Your doctor may adjust your dose if needed. The dose is usually not more than 40 mg per day. Children—Use and dose must be determined by your doctor. Missed Dose

If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Precautions While Using Glucotrol XL

It is very important that your doctor check your progress at regular visits to make sure that this medicine is working properly. Blood and urine tests may be needed to check for unwanted effects.

It is very important to follow carefully any instructions from your health care team about:

Alcohol—Drinking alcohol may cause severe low blood sugar. Discuss this with your health care team. Counseling—Other family members need to learn how to prevent side effects or help with side effects if they occur. Also, patients with diabetes may need special counseling about diabetes medicine dosing changes that might occur because of lifestyle changes, such as changes in exercise and diet. Furthermore, counseling on contraception and pregnancy may be needed because of the problems that can occur in patients with diabetes during pregnancy. Travel—Keep your recent prescription and your medical history with you. Be prepared for an emergency as you would normally. Make allowances for changing time zones and keep your meal times as close as possible to your usual meal times. In case of emergency—There may be a time when you need emergency help for a problem caused by your diabetes. You need to be prepared for these emergencies. It is a good idea to wear a medical identification (ID) bracelet or neck chain at all times. Also, carry an ID card in your wallet or purse that says you have diabetes and a list of all of your medicines.

Check with your doctor right away if you start having chest pain or discomfort; nausea; pain or discomfort in the arms, jaw, back, or neck; shortness of breath; sweating; or vomiting while you are using this medicine. These may be symptoms of a serious heart problem, including a heart attack.

Glipizide can cause hypoglycemia (low blood sugar). However, this can also occur if you delay or miss a meal or snack, drink alcohol, exercise more than usual, cannot eat because of nausea or vomiting, take certain medicines, or take glipizide with another type of diabetes medicine. The symptoms of low blood sugar must be treated before they lead to unconsciousness (passing out). Different people feel different symptoms of low blood sugar. It is important that you learn which symptoms of low blood sugar you usually have so you can treat it quickly.

Symptoms of low blood sugar include anxiety; behavior change similar to being drunk; blurred vision; cold sweats; confusion; cool, pale skin; difficulty with thinking; drowsiness; excessive hunger; fast heartbeat; headache (continuing); nausea; nervousness; nightmares; restless sleep; shakiness; slurred speech; or unusual tiredness or weakness.

If symptoms of low blood sugar occur, eat glucose tablets or gel, corn syrup, honey, or sugar cubes; or drink fruit juice, non-diet soft drink, or sugar dissolved in water. Also, check your blood for low blood sugar. Glucagon is used in emergency situations when severe symptoms such as seizures (convulsions) or unconsciousness occur. Have a glucagon kit available, along with a syringe or needle, and know how to use it. Members of your household also should know how to use it.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

Glucotrol XL Side Effects

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

Less common Anxiety blurred vision burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings chills cold sweats coma confusion cool, pale skin depression difficulty with moving dizziness fainting fast heartbeat headache increased hunger joint pain leg cramps muscle aching or cramping muscle pain or stiffness nausea nervousness nightmares pain in the joints problems in urination or increase in the amount of urine seizures shakiness slurred speech sweating swollen joints unusual tiredness or weakness Rare Abdominal or stomach pain bloating bloody or black, tarry stools body aches or pain burning, dry, or itching eyes clay-colored stools congestion constipation cough dark urine decreased vision or other changes in vision diarrhea difficult or labored breathing difficult or painful urination dryness or soreness of the throat excessive tearing fainting fast, slow, or irregular heartbeat feeling of warmth fever heartburn hoarseness indigestion itching loss of appetite pain in the eye pounding in the ears rash redness of the face, neck, arms and occasionally, upper chest redness, pain, or swelling of the eye, eyelid, or inner lining of the eyelid runny nose severe stomach pain shortness of breath tender, swollen glands in the neck tightness in the chest trouble in swallowing unpleasant breath odor voice changes vomiting of blood or material that looks like coffee grounds wheezing yellow eyes or skin Incidence not known Agitation back or leg pains bleeding gums blood in the urine or stools chest pain convulsions decreased urine output fluid-filled skin blisters general body swelling general feeling of tiredness or weakness high fever hostility increased thirst irritability lethargy light-colored stools lower back or side pain muscle twitching nosebleeds pinpoint red pots on the skin rapid weight gain sensitivity to the sun skin thinness sores, ulcers, or white spots on the lips or in the mouth stupor swelling of the face, ankles, or hands unusual bleeding or bruising

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common Indigestion passing of gas Less common Acid or sour stomach belching excess air or gas in the stomach or intestines full feeling pain sleeplessness sneezing stuffy nose trouble sleeping unable to sleep Rare Decreased interest in sexual intercourse dizziness or lightheadedness excessive muscle tone feeling of constant movement of self or surroundings flushing or redness of the skin headache, severe and throbbing hives or welts inability to have or keep an erection loss in sexual ability, desire, drive, or performance mood or mental changes muscle stiffness muscle tension or tightness sensation of spinning skin rash, encrusted, scaly, and oozing sleepiness or unusual drowsiness unusually warm skin walking in unusual manner weight loss Incidence not known Increased sensitivity of the skin to sunlight severe sunburn

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

See also: Glucotrol XL side effects (in more detail)

The information contained in the Thomson Reuters Micromedex products as delivered by Drugs.com is intended as an educational aid only. It is not intended as medical advice for individual conditions or treatment. It is not a substitute for a medical exam, nor does it replace the need for services provided by medical professionals. Talk to your doctor, nurse or pharmacist before taking any prescription or over the counter drugs (including any herbal medicines or supplements) or following any treatment or regimen. Only your doctor, nurse, or pharmacist can provide you with advice on what is safe and effective for you.

The use of the Thomson Reuters Healthcare products is at your sole risk. These products are provided "AS IS" and "as available" for use, without warranties of any kind, either express or implied. Thomson Reuters Healthcare and Drugs.com make no representation or warranty as to the accuracy, reliability, timeliness, usefulness or completeness of any of the information contained in the products. Additionally, THOMSON REUTERS HEALTHCARE MAKES NO REPRESENTATION OR WARRANTIES AS TO THE OPINIONS OR OTHER SERVICE OR DATA YOU MAY ACCESS, DOWNLOAD OR USE AS A RESULT OF USE OF THE THOMSON REUTERS HEALTHCARE PRODUCTS. ALL IMPLIED WARRANTIES OF MERCHANTABILITY AND FITNESS FOR A PARTICULAR PURPOSE OR USE ARE HEREBY EXCLUDED. Thomson Reuters Healthcare does not assume any responsibility or risk for your use of the Thomson Reuters Healthcare products.

More Glucotrol XL resources Glucotrol XL Side Effects (in more detail) Glucotrol XL Use in Pregnancy & Breastfeeding Drug Images Glucotrol XL Drug Interactions Glucotrol XL Support Group 0 Reviews for Glucotrol XL - Add your own review/rating Glucotrol XL Extended-Release Tablets MedFacts Consumer Leaflet (Wolters Kluwer) Glucotrol XL Prescribing Information (FDA) Glipizide Prescribing Information (FDA) Glipizide Professional Patient Advice (Wolters Kluwer) Glipizide Monograph (AHFS DI) Glipizide MedFacts Consumer Leaflet (Wolters Kluwer) Glipizide XL Prescribing Information (FDA) Glucotrol Consumer Overview Glucotrol Prescribing Information (FDA) Compare Glucotrol XL with other medications Diabetes, Type 2



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